What is bone implantation – augmentation and when is it used?
Bone augmentation (upgrading, enlargement) is the series of procedures that are undertaken to increase bone volume to allow the placement of a dental implant. All procedures generally involve the addition of bone material. It can be an autologous bone (a bone graft taken from another place in the patient’s mouth) or an artificial bone.
Augmentation of bone and soft tissue of the oral cavity is an important procedure in implantology and one should not run away from it. It is necessary that there is a sufficient amount of bone around the implant, because it will enable the longevity of the implant itself. Insufficient bone leads to problems and inflammation around the implant, called periimplantitis and later to implant rejection. By pulling the thin bone, the gums are also pulled, and the result is an infection and a very bad aesthetic effect.
If there is a lack of hard or soft tissue, the patient will not be satisfied with the final results of the implant placement.
Soft tissue augmentation is done when there is a lack of soft tissue around the dental implant. It can be done by various methods, during the augmentation of bone tissue or as a special procedure after implantation or during the opening of the implant.
Today’s technology is so advanced that even if you do not have a satisfactory structure or bone density in which the implant should be placed – there are methods that solve this problem. The path to a beautiful smile has never been easier, because surgical techniques enable bone upgrades in order to obtain natural newly created bone – the basis for dental implants.
When is it time to augment or upgrade a bone?
It is always time to upgrade the bone when it is missing. The sooner we “catch” the process of bone loss (due to infections, periodontitis, tooth extraction), the greater the success of the upgrade.
Bone augmentation can be performed by adding bone in height (vertical augmentation), in width (horizontal) or as a combined augmentation.
Once a natural tooth is lost, the jawbone atrophies (thins) in that part. It is a completely natural process, similar to muscle atrophy if you do not engage in physical activities. If before the loss of the tooth, its root was affected by the inflammatory process, then the resorption of the bone will be faster and to a greater extent, because in that case, the bacterial infection additionally destroys the bone. In order for a dental implant to fulfill its function, it must be completely in the bone. If the bone volume is not satisfactory, bone augmentation must be performed before the implant is placed.
Bone augmentation is often necessary when implant placement in the anterior, aesthetic regions of the jaw. Since the gum or soft tissue follows the contours of the bone below, any bone defect leads to a lack of gums, or to a poor aesthetic result.
If the patient has to remove a tooth and install a dental implant in its place, the best solution is, if possible, to remove the tooth and implant at the same time, and to augment the bone. In that way, we place the implant on the place where the tooth was just extracted, and the best natural bone is installed in the remaining cavities. This stops or slows down the processes of bone resorption, and shortens the recovery time. All inflammatory processes must be repaired before implant procedures.
What if there are not enough bones to implant?
If the patient has lost a tooth a long time ago, and there is not enough bone for implant placement, in that case the lost bone should be replaced first in order to create a quality base for implant placement. The implantation of artificial or natural bone follows and after that procedure it is necessary to wait from 4 to 5 months if natural bone was used and from 6 to 9 months if artificial bone was used, before implant placement.
If a dental implant is placed in the upper jaw (maxilla), the bottom of the maxillary sinus is often set low. In this case, the bottom of the sinus is lifted, which is also called a sinus lift.
Loss of the posterior upper teeth leads to atrophy of the jawbone and lowering of the bottom of the maxillary sinus. In order to place the implant in that area, it is necessary to raise the bottom of the maxillary sinus and make a place for the implant. This is where our top dentists who deal with the implantation of artificial bone (augmentation) enter the scene.
Fortunately, today we have short and narrow implants from the world’s leading companies, and bone augmentation is often unnecessary due to the use of these implants.
What is an artificial bone and how does the patient’s body accept it?
The artificial bone is made up of tiny granules that are placed in the bone under the membrane. They serve as a substrate in which the bone cells created by the human body are deposited. In about 12 months, the artificial bone cells disappear and are replaced by natural bone cells.
In addition to enabling the installation of a dental implant, bone augmentation stops the retraction of the gums and further decay of the jawbone, and thus the collapse of the adjacent teeth. The success of artificial bone implantation is great if it is performed correctly.
As a rule, the body always accepts the granules and the body itself begins bone regeneration.
Is it better to use natural bone?
It is definitely always better to use the patient’s natural bone for each bone augmentation, but this often requires two operative fields – the place where the bone is placed and the donor site. The use of the patient’s natural bone has been shown to significantly increase the success of bone augmentation and should be used in all situations where possible.
Is bone augmentation a painful procedure?
This surgery is performed under local anesthesia, so it is absolutely painless during the intervention. Postoperatively, there may be certain pains that stop with the use of analgesics. There is always a smaller or larger swelling with or without bruising. The postoperative period lasts about 10 days, after which the sutures are removed.
After the surgery, it takes some time for the used natural or artificial bone to form a sufficiently strong bone that can hold the dental implant.
In order to speed up the whole process and avoid two surgeries, the lifting of the sinus floor, implantation of artificial bone (augmentation) and placement of a dental implant are usually performed in one procedure.
How long does it take to recover from an artificial bone implant?
Every surgical or operative procedure requires special care that must follow after the operation. After bone implantation, there is always a smaller or larger swelling with or without accompanying bruises. It is desirable to put cold compresses on the procedure to reduce swelling.
In case of pain, it is necessary to take analgesics recommended by our specialist doctor. The sutures are usually removed 7 to 10 days after the procedure. The mouth should not be rinsed immediately after the surgery, and after 48 hours it should be rinsed with the prescribed antiseptic, provided that there is no bleeding. Rinsing with antiseptic is repeated 2 to 3 weeks after the procedure.
For some time, the patient must be patient with solid foods (or those with a grainy consistency) because food particles can be drawn into the wound. Only soft or liquid foods are recommended after surgery, while hot foods should be avoided.